Cognitive Pearl #098 Suicide & Hope

Wow. That’s a question that I don’t get asked everyday. As loaded as the question was however I felt it was important to give the answer. Not ‘an’ answer.

The answer.

‘Actually, I am a bit worried that you might suicide but I’m more worried that you’ll miss an opportunity which lays before you.’

Now it was his turn to be caught off-guard.

So I explained that as I saw it, he was dealing with some terrifying issues. These were issues (relating to family obligations) that he was finally taking on in a manner that offered the best chance of his coming out the other side. The size of the prize makes the journey fraught with danger, suicide being a small risk compared with the bigger risk of bailing out of the process. In the meantime we would continue to work the process and in the vernacular of my youth, let the chips fall where they may.

Content with my explanation he left a few minutes later when our session was over. The after-image as he left: determination and confidence.

Suicidality has fascinated me since entering the profession. It’s struck me that overall, all of the holy trinity of professions (psychiatry, social work, and psychology) seem to be quite confused by the whole topic. Whether it’s predicting suicidality or what to do to prevent it, professional consensus remains elusive. Societal expectation that somehow we soothsayers of the human mind should ‘know’ who kills himself and who doesn’t even more ironic.

For me however suicidality goes to the heart of my approach to cognitive therapy. And that’s the topic I’ll be fleshing out in the coming posts.